Relationship Manager - Affiliated Providers

About Southern Cross Health Insurance

Southern Cross Health Insurance is dedicated to promoting a healthier New Zealand by empowering members to lead well and longer lives. As a New Zealand-owned and member-focused organisation, it provides peace of mind by facilitating timely access to quality healthcare, encouraging healthier lifestyles, and guiding positive changes within the healthcare system. The company nurtures a culture where its employees can thrive and be proud of their impact.

Role Overview

The Affiliated Provider Relationship Manager is responsible for maintaining strong relationships with contracted healthcare providers while assisting members with prior approval and eligibility assessments. This role involves coordination across departments to resolve queries, ensure quality service, and achieve beneficial outcomes for both providers and members. The position is based in Auckland or Hamilton, offering diverse responsibilities, a collaborative team atmosphere, and opportunities for professional growth.

Key Duties

• Efficiently evaluate and process prior approvals, claims, and top-up requests with accuracy.
• Deliver clear explanations to members regarding eligibility criteria, coverage, shortfalls, and considerations related to ACC or treatment injuries.
• Foster and maintain strong, constructive relationships with affiliated healthcare providers, acting as the primary contact for daily inquiries.
• Handle multiple tasks such as phone calls, emails, provider applications, and follow-ups simultaneously.
• Partner effectively with Contact Centre, Healthcare Partnerships, Partnership Managers, and other internal teams to address issues promptly.
• Recognize and escalate risks involving eligibility problems or pre-existing conditions.

Ideal Candidate Profile

• Proven experience in customer service, relationship management, or roles focusing on stakeholder engagement.
• Background in claims assessment or decision-making processes within relevant environments.
• Strong communication abilities combined with relationship-building expertise.
• Exceptional attention to detail and prudent judgment skills.
• Capability to manage competing priorities proactively and independently.
• Comfortable utilizing technology and navigating multiple systems efficiently in a dynamic workplace.

Additional Information

This role offers the chance to positively influence the healthcare experience of members while building significant networks with healthcare providers. Southern Cross Health Insurance is committed to inclusion, demonstrated by its adoption of the Pride Pledge and active employee-led Diversity, Equity and Inclusion groups, which include networks supporting Rainbow, Māori, Pasifika, Neurodiversity, and Whānau communities. Candidates who resonate with these values are encouraged to apply.